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Small Animal Medicine > Cough Diseases > Flashcards

Cough Diseases Flashcards

1
Q

When a dog presents with a cough, what differentials are more likely for an older dog vs. a younger dog?

A

Young: infectious

Older: chronic bronchitis, neoplasia, cardiac disease

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2
Q

If an animal is coughing due to CHF, it should be tachycardic. T/F?

A

True

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3
Q

What easy diagnostic test should be performed on all animals with a chronic cough?

A

fecal

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4
Q

What is the most common parasite found in the lungs of dogs to cause clinical disease?

A

Filaroides osleri (canine lungworm)

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5
Q

If a feline presents with a chronic illness, which diagnostic tests should be performed?

A

FeLV and FIV snap tests

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6
Q

What type of radiograph should be taken to see an intrathoracic collapse? Extrathoracic collapse?

A

Intra= expiratory film

Extra= inspiratory film

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7
Q

When would performing a transthoracic aspirate be indicated?

A

diffuse pulmonary disease

solitary lung mass

pneumonia

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8
Q

What is the location used for obtaining a transthoracic aspirate with diffuse disease?

A

7-9th intercostal spaces

2/3 the distance from the costochondral junction to the spine

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9
Q

What is the most common complication of transthoracic aspirates?

A

pneumothorax

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10
Q

When is a tracheal wash indicated? When would it not be helpful for diagnosis?

A

Indicated for airway and diffuse alveolar disease

Not helpful with interstitial and focal disease

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11
Q

For a transtracheal wash, where is the catheter inserted?

A

cricothyroid ligament

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12
Q

Which procedure requires general anesthesia (TTW) or (Endotracheal wash)?

A

Endotracheal wash

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13
Q

What is the main purpose of performing a bronchoscopy?

A

collect samples from the lower respiratory tract

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14
Q

When is BAL indicated?

A

Diseases affecting the small airways, alveoli, +/- interstitium

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15
Q

Which cell type should predominate on cytological analysis of BAL?

A

large mononuclear cells

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16
Q

Causes of acute cough?

A

Most common: Pneumonia & CN Infectious respiratory disease

Pulmonary Thromboembolism (PTE)

Intrathoracic tracheal or bronchial foreign body

Non-cardiogenic pulmonary edema

Eosinophilic bronchopneumopathy

Post-nasal drip Hemorrhage

Congestive Heart failure

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17
Q

T/F Dogs with CN Infectious respiratory disease typically have systemic signs of illness.

A

FALSE

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18
Q

Does CIRD need to be treated?

A

Depends on if it’s complicated or not

Uncomplicated- often self-limiting (1-3 weeks) abx not usually needed

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19
Q

Which abx if used are a good first choice for CIRD?

A

Doxycycline

trimethoprim/sulfas
amoxicillin-clavulanate

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20
Q

Antitussive therapy is contraindicated in dogs with bacterial pneumonia. T/F?

A

True

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21
Q

What is a good first line choice for bacterial pneumonia in terms of abx? How long should your course be?

A

Ampicillin, cefazolin, TMS, aminoglycoside
1 week past resolution of clinical signs and rads signs

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22
Q

What virus is most likely to result in pneumonia?

A

distemper

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23
Q

What is the difference in the type of inflammation seen with bacterial vs. fungal pneumonia?

A

Bacterial: neutrophilic

Fungal: pyogranulomatous

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24
Q

How long should your course of antifungals be for a fungal pneumonia?

A

3 months past resolution of clinical signs

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25
Q

What radiographic signs will be evident with aspiration pneumonia?

A

an alveolar pattern in the R-middle lung lobe

+/- megaesophagus

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26
Q

When would abx be indicated in a patient with aspiration pneumonia?

A

no improvement after 2-3 days

inflammatory leukogram is getting worse

fever develops

animal has been on H2/PPI

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27
Q

Differentials for chronic cough

A

collapsing trachea

chronic bronchitis (canines)

Bronchiectasis

Parasites

eosinophilic bronchopneumopathy

Primary ciliary dyskinesis

others (Feline bronchitis/asthma, pulmonary neoplasia, cardiac disease heart enlargement/CHF)

28
Q

Tracheal collapse results from narrowing of the tracheal lumen from what two processes?

A

flattening of the cartilaginous rings

redundancy of the dorsal tracheal membrane

29
Q

Which age and breed of dog are most predisposed to tracheal collapse?

A

toy breeds

middle age to older

30
Q

What is the classic sign associated with tracheal collape?

A

goose honk

31
Q

When performing radiographs, when will you be able to visualize intra vs. extra-thoracic collapse?

A

Intrathroacic= expiratory films

Extrathoracic= inspiratory films

32
Q

A 10-year-old Yorkie presents with tracheal collapse and is in respiratory distress. What is the emergency treatment? Why are opioids often added to the treatment plan?

A

Oxygen therapy +/- intubation/tracheostomy

Anxiolytic PRN (diazepam/ace) + opioid (butorphanol/hydro)

Anti-inflammatory

33
Q

What environmental changes can be made to improve tracheal collapse?

A

weight management

reduce exposure to respiratory irritants (smoke)

minimize exercise

replace collar with harness

34
Q

What are the two preferred antitussives to use with tracheal collapse?

A

butorphanol

hydrocodone

35
Q

How does Lomotil (diphenoxylate hydrochloride and atropine) act to help with medical management for tracheal collapse?

A

diphenoxylate = acts as opioid antitussive

atropine= reduces the amount of mucus secreted by the lower airways + an antimuscarinic bronchodilator

36
Q

What two side effects of steroids make their use in cases of tracheal collapse less desirable?

A

tachypnea

weight gain

37
Q

When would bronchodilators (methyllxanthines and beta agonists) be considered for use in cases of tracheal collapse?

A

WITH concurrent small airway disease

38
Q

What is the salvage procedure performed for tracheal collapse? What are the associated complications?

A

placement of internal stents for an extrathoracic collapse

infection, stent fracture or migration, obstruction from granulation tissue

39
Q

What is the most common sign for chronic canine bronchitis?

A

dry cough exacerbated by exercise/excitement progressively getting worse over weeks-years

40
Q

Culture (mycoplasma & aerobic) should always be done on chronic canine bronchitis cases. T/F?

A

TRUE

41
Q

What treatment is generally most important for reducing clinical signs with CN chronic bronchitis?

A

Glucocorticoids (prednisone 1 mg/kg for 10 days, then taper 0.5-1 mg/kg q 48hrs)

42
Q

Why is the treatment for CN chronic bronchitis more focused on reduction of clinical signs rather than a cure?

A

most of the damage to the lungs is irreversible

43
Q

What is the MOA for B-agonists in acting as a bronchodilator to help with canine chronic bronchitis?

A

relaxation of bronchial smooth muscle

increased mucociliary transport rates
stabilization of mast cell membranes

reduction in vascular permeability

44
Q

When are bronchodilators indicated in a dog with chronic bronchitis?

A

exercise intolerance or wheezing

45
Q

A canine presents with chronic bronchitis and is wheezing constantly the owner reports. What would be your treatment plan?

A

Glucocorticoids (Pred 1 mg/kg then taper)

Bronchodilator (tertbutaline 1 mg/kg BID/albuterol 0.02 BID mg/kg 5 days, then 0.05 mg/kg if no improvement, d/c after 2 weeks no improvement or methlxanthines can be used)

46
Q

A Golden Retriever with chronic bronchitis was given a bronchodilator. What are the side effects of B-agonists and methylxanthines that you would expect?

A

Both restlessness

B-agonists: skeletal muscle tremors

47
Q

What would be indications for use of abx in canine chronic bronchitis?

A

Evidence of bronchiectasis in a newly dx animal

Acute exacerbation of signs

48
Q

What # of bacterial colony count are significant and would indicate abx use in cases of CN chronic bronchitis?

A

1 x 10^4 organisms/mL

49
Q

A 8 year old beagle with chronic bronchitis has a dry, non-productive cough that keeps both the dog and owner up at night. What treatment is an option for this dog? What is the most common side effect?

A

Cough suppressant:

Hydrocodone bitartrate (0.22 mg/kg 2-4x/day)

Side effects: drowsiness & constipation

50
Q

What is the major benefit to administering inhaled steroids (e.g. fluticasone and beclamethasone) vs. oral steroids?

A

Less systemic effects of steroids

51
Q

In general what the treatment options for canine chronic bronchitis?

A

Glucocorticoids

Bronchodilators w/ EI or wheezing

Abx w/ significant culture

Cough suppressants when dry, nonproductive & disruptive

52
Q

Define Bronchiectasis

A

permanent dilation of the bronchi

53
Q

What is often indicated in the treatment of bronchiectasis?

A

antibiotics b/c susceptible to infection

54
Q

What are the primary parasites of the lungs?

A

Oslerus (Filaroides) osleri

Paragonimus kellicotti

Aelurostrongylus abstrusus

55
Q

In which species of parasites are larval migrans through the lungs common?

A

Toxocara spp

Ancylostomum

Strongyloides

56
Q

What is the cause of eosinophilic bronchopneumopathy?

A

Idiopathic

57
Q

What is the most common clinical sign of EBP and what age are the dogs with this condition typically?

A

A cough is the most common clinical sign, occurring in the majority of dogs (4-6 yrs, young adults). The cough is usually harsh and sonorous, persistent, and frequently followed by gagging and retching

58
Q

What are the rule outs often associated with EBP?

A

heartworm dz

parasites

lymphoma

59
Q

What pattern is often seen with EBP?

A

bronchointerstitial

60
Q

On a BAL from a dog you suspect to have EBP, what would be a supportive finding?

A

increase in the total number of cells in the fluid as increase in the percentage of eosinophils (up to 25%) and neutrophils

61
Q

What is the treatment for EBP?

A

STEROIDS

62
Q

What is the congenital defect associated with Primary Ciliary Dyskinesis? Which age & breed of dog are over-represented?

A

congenital defect/s in the ciliary microtubule structure

< 2 year old

English Pointers and Springer spaniels

63
Q

A 1 year old dog presents for recurrent respiratory infections. What is a key differential to have on your list? What is the prognosis?

A

Primary ciliary dyskinesis

Poor

64
Q

A young dog with primary ciliary dyskinesis often also has what other concurrent conditions?

A

Infertile (cilia of sperm/fallopian tubes does not fxn properly)

Otitis externa

65
Q

What differentials are common for acute cough?

A

Tracheitis/tracheobronchitis

pneumonia, PTE

Parasites (or chronic)

CHF

66
Q

What differentials are common for chronic cough?

A

tracheitis/tracheobronchitis

Bronchitis

asthma

bronchiectasis

parasites

atrial enlargement/pulmonary hypertension

67
Q
A

Small Animal Medicine (7 decks)

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